A 21-year-old man presented to the ED with a 2-month history of chest pain. During the preceding several days, he described hearing “sloshes” in his chest with positional changes, which ultimately prompted his visit. He has a history of epilepsy and was compliant with his phenytoin therapy.
Further questioning suggested a history of a possible fall 2 months prior, while intoxicated. Subsequent to this event, he had been having intermittent pain in his chest. He denied fevers, night sweats, chills, cough, or shortness of breath. He denied ever having similar symptoms in the past. The pain was not worse on exertion nor positional. He is unemployed and uses marijuana occasionally. He denied any other drug use.